| NPI | 1811576184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172A00000X Driver | |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-04-05 |